后路腰椎间盘镜手术治疗腰椎间盘突出症失误分析

目的:分析后路第二代腰椎间盘镜手术治疗腰椎间盘突出症失误的主要因素。方法:通过对临床资料和X线片、CT、MR等影响资料的分析,回顾性分析126例后路腰椎间盘镜手术4例失误病例。结果:4例中1例术前诊断不全面,1例高龄、伴椎间盘钙化,椎管狭窄,适应证选择不当。1例术中椎管狭窄神经通道减压不充分,1例双间隙突出,对髓核摘除不够,对突出间隙神经根管外口减压不够。结论:腰椎间盘突出症后路椎间盘镜手术失误的主要原因是手术适应证选择不当和手术技术失误。

Lapses of microendoscopic discectomy for lumbar disc herniation

Objective:To describe and discuss the causes for lapsus in the primary operation for lumbar disc herniation using METRx Ⅱ.Method:Clinical data and image data of 126 patients(76 men,50 female) who underwent posterior microendoscopic discectomy(MED) were collected for retrospective study.4 patients with unsatisfied curative effect were selected and analysised.Results:The reasons accounted for the lapses of primary MED in 4 cases were found as follows:1 case was misdiagnosed,1 was elderly with calcification of posterior margin of lumbar disc,1 was inappropriately indicated,and 1 had double-levels lumbar disc herniation and incomplete decompression.Conclusion:The main lapses of MED are inappropriate surgical indication and inexperience surgical technology.